WASHINGTON — A presidential commission created to address the nation’s devastating opioid crisis released a sweeping set of recommendations Wednesday that included the creation of a nationwide system of drug courts, the development of non-addictive painkillers and a national campaign aimed at educating the public about the dangers of drug use.

The 56 recommendations, contained in a 131-page report by the President’s Commission on Combating Drug Addiction and the Opioid Crisis, included no new funding to address the crisis. But Commission Chairman Chris Christie, the New Jersey governor, said that coming up with money to battle the crisis is Congress’ job, and the report included recommendations of programs for Congress to fund.

President Donald Trump, Christie said, "cannot appropriate these funds by himself. The Constitution doesn’t permit it. They (members of Congress) must step up to appropriate the funds ... to do what needs to be done."

Among the more-sweeping recommendations is that the Department of Justice broadly establish federal drug courts in all 93 federal judicial districts. They recommend that people with a substance-use disorder who violate probation by taking drugs be diverted into drug courts, not prisons.

Cheri Walter, CEO of the Ohio Association of County Behavioral Health Authorities, said she supports the idea of drug courts — as long as they’re funded.

"What I don’t want to see is them divert treatment money to drug courts," she said. "If you have a drug court, you have to have some funding to pay for it."

She said drug courts have worked well in Ohio.

"I know people whose main issue is addiction," she said. "If they get the treatment, they’re better served, as is the community."

Since Trump named the crisis a public health emergency last week, Walter already has seen one positive development: Wednesday, she got a letter from the Center for Medicare and Medicaid Services announcing that it is loosening restrictions that limited Medicaid-funded drug treatment to centers with 16 or fewer beds.

The commission also recommended the expanded availability of medication-assisted therapies; making the opioid-overdose antidote naloxone more available to first responders; beefing up penalties for those who traffic fentanyl and other synthetic opioids; and creating additional research initiatives for vulnerable populations such as pregnant women and babies born addicted.

Christie said the crisis claims an average of 175 lives a day in the U.S.

"If a terrorist organization was killing 175 Americans a day on American soil, what would you be willing to pay to make it stop?" he asked. "I think we’d be willing to do anything and everything to make it stop. And that’s the way we now need to see this because this is an attack from within. We are killing ourselves."

The recommendations include the endorsement of the STOP Act, a bill pushed by Ohio Sen. Rob Portman in the Senate and Ohio Rep. Pat Tiberi in the House that would require Postal Service shipments from foreign countries to include electronic advance data in the hopes of preventing fentanyl and carfentanil from coming to America through the mail. Sen. Sherrod Brown, D-Ohio, has co-sponsored the bill in the Senate, and most of the Ohio delegation is co-sponsoring the House bill.

The recommendations also include support for a Portman measure that would require the use of prescription-drug monitoring programs in all states that receive certain federal dollars to fight the opioid epidemic. Portman called for the Senate to pass both bills quickly and said he is "hopeful that Congress will act with urgency in the coming weeks and months to review and address" the measures.

And the suggestions include components of Brown’s legislation to provide Customs and Border Patrol agents with screening devices to detect fentanyl at the borders before it can reach Ohio communities. Portman has cosponsored that bill.

"Anything we can do to stop fentanyl at our borders will help keep it from reaching the Ohio communities where it is taking lives," said Brown. "Better equipping these agents with detection devices is a commonsense step we can take right now to stem the flow of these drugs."

Brown, however cautioned that the report "cannot be the end of the administration’s attention to this issue."

"I urge President Trump to use the declaration he made last week to put real money into this public health crisis," he said.

jwehrman@dispatch.com

@jessicawehrman

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